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Home My WebLink About2001-P03866 - re-roof PERMIT CIT`�' `��= ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po3g66 Crystal Bay, Minnesota 55323 Per'mit Type: Minor Alterations (952) 249-4600 Date Issued: si3o�2ooi SITE ADDRESS: 2525 Kelly Ave EXCELSIOR,MN 55331 PID: 2o-ii�-23-ii-oo22 DESCRIPTION: Proposed Use: icesidentiai Census Code 434 Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 167.25 Valuation: $ 8,690.00 State Surcharge Fee: $ 4.35 TOTAL FEE: $ 171.60 APPLICANT: Western Cedar Supply OWNER: K G HEIMBACH&R E HEIMBACH 9700 13th Ave 2525 KELLY AVE Plymouth,MN 55441 EXCELSIOR MN 55331 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � � �r , �� 0��7 �� APPLICANT PERMITEE SI NATURE ISS ED BY SIGNATiJRE Copies: City,Applicant,Assessor,Finance Page 1 � Total Fe: $ Date Received: Entered By: Permit#: ��3�. o/ CITY OF ORONO - BUII�DING PERMIT APPLICATION All information must be submitted in full before plan review will be started. � (please print all information) � THE APPLICANT IS: (circle one) OWNER CONTRACTOR JOB SITE ADDRESS: � � �C/l �� ZIP: 55 3 3 � NAME OF OWNER: /��' . ��ir"'�G� PHO�TE: (hom (work} �IAII..ING ADDRESS: l��'��— . CITY: �,rce�� ZIP: CONTRACTOR: " C� C�O`G�/ � PHO�TE: �3 -SY�rc��c.�' CONTACT PERSON: �/'en�- � MOBILE/PAGER: MAILING ADDRESS: ��ov 1 3 ��v• CI'TY: ply�_ZIP: 5.5� STATE LICENSE: # ��55 � ARCHITECT/ENGINEER: � PHO\'E: MAILING ADDRFSS: CITY: ZIP: NtilV�; REGISTRATION# � TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �C�GrI��//�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: � GARAGE STALLS: ATT: � DET. � ,� - - 9 � 6 ESTIlVIATED CONSTRUCTION VALUATION (excluding land): S �1 � 6 I hereby apply for a building pernut and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is not a perm.it and work is not to start without a permit; and that the work will be in accordance with the approved plan. ' APPLICANT'S SIGNATURE: �� DATE: 5��t NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � y _ � - Sec.13.04 RIGIiTS OF SUBJECTS OF D:�TA Subd. 1. Type of data. The righcs of individual on whom the dara is stor:3 or[o be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An icdividual asYcd w supply privam or confidenrial data conceming himsdf shall be informed of: (a)the purpose and incended use of[he cequesud dam wi3un the colleccing Stam agency,polidcal subdivision,or stacewide rysxem; (b)wheeher he may refuse oY is legally required to supply che requested dan:(c)any]mown eonsequence arising from his supplying or refusing to supply privace or conndendal data;and(d)the idendry of other persoas or enades aechorized by state or fede�al[aw to receive the data.:This requirement shail no[appty when an individual is asked to supply invesdgadve dara,pursvsac co seccon 13.82,subdivision 5, to a law enforcement officer. 'Ihe commissioner of re�enue mav alace che noace reauirod crd-r this subdivision in che individual income tax or prooem tax refund instructions inscezd of on those forms. Subd.3. Aecess to data by individuai. Upon request to a responsible a�choriry,an individual shall be informed whether he is the subject of scored data on individuals,and whe[her ic is classified as pubtic,privam or confidenrial. Upon his further request,an individual who is the subjecc of scorni private or public daea on individuals shall be shown the dara wiaouc any c'nar3e to him and;if he desires, shall be informed of the coacent and meaning of[hac daca. After an individual has been shown�he priva�,dan and in;ormed of ict meaning,the dara need not be disclosed to him for six mon[hs ehereafcer unless a dispute or acaon pursuanc to[his secdon is pending or addidonal dara on the individual has been collected or creaced. The responsible auchoriry shall provide copies of the private or public data nYon reques:by the individuai subject of che data. The msponsible authoriry may require che requesting person to pay the actual cosu of makin¢,cerying,and compiling the copies. The responsible authoriry shall comply immediacely,if possib(=,wich any rcquest made pursuant to this subdivision,or wi[hin five days of the date of che requesc,exciuding Saturdays,Sundays and legal holidays,if icamediate compliance is no[possible. If he cannot comply with the request wirhin chac rime,he shall so inform the individual,and may have an addirional five dar s wichin which to compty wich the request,excluding Satucdays, Sundays and legat holidays. Subd.4. Procedure when data ic not accurate or complete. an individual may contest the accuracy or complereness of public or pri�ate dara concerning himself. To exercise this righ[,an individual shal!nodfy ia wridng cie responsible authoriry describing che namre of the disagreemenc. The responsible auchoriry shall within 30 days either: (a)correct the dara fcund to be inaccurate or incomplete and attempc to nodfy past recipienrs of inaccurate or incomplete data, including recipiena named by che individi:J:or(b)codfy the individual that he believes the data to be correcG Data in dispuc�shall be disclosed only if[he individual's stacemene of disagres�:nc is i�clsded with the d'uclosed dara. The de�ecminarion of the rasponsible auehoriry may be appealad pursuacc w the provisions of the adminisaarive procedure act reladng to contested cases. . DATA PRIVaCY AD�'ISORY In accordance with M.S. 13.04,Subd.2, "Rights of subjects of da[a", we would like to inform you that your reauest for a permit or license from the Ciry of Orono or any of iU depar�ents may require you to furnish cenain privace or confidencial information. You are notified that: 1, The information you furnish will be used to de:emune your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the,City deny the permit or license. 3, The information may be shared with ocher loc�l, state or federal agencies to the excent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become . . public. �. You have certain ri,ghts under M.S. 13.04�(availabie upon requesc) to review private data on yourself. 6, Your full name is required to process this applica[ion or perm.ic. J� Finc Middle �t �ddress • Ciry Stace Zip Phone I understand my riohts as stated above. �� — Signacure